The Incomplete Fissure Sign

Radiology. May, 2008  |  Pubmed ID: 18430885

Peritoneal Sarcoidosis: the Role of Imaging in Diagnosis

Gastroenterology & Hepatology. Dec, 2009  |  Pubmed ID: 20567532

Microwave Tumor Ablation: Mechanism of Action, Clinical Results, and Devices

Journal of Vascular and Interventional Radiology : JVIR. Aug, 2010  |  Pubmed ID: 20656229

Microwave ablation uses dielectric hysteresis to produce direct volume heating of tissue. Microwaves are capable of propagating through many tissue types, even those with high impedance such as lung or bone, with less susceptibility to "heat-sink" effects along vessels. Microwaves are highly conducive to the use of multiple applicators, showing the synergy seen with other energies, but also the potential capability for phasing of the electromagnetic field. As a result, larger, more customizable ablation zones may be created in less time. Although multiple microwave ablation systems are currently available, further study and continued development are needed.

Bowel Preparation for CT Colonography: Blinded Comparison of Magnesium Citrate and Sodium Phosphate for Catharsis

Radiology. Jan, 2010  |  Pubmed ID: 20032148

To compare colonic cleansing and fluid retention of double-dose magnesium citrate with those of single-dose sodium phosphate in patients undergoing computed tomographic (CT) colonography.

Computed Tomographic Colonography

The Surgical Clinics of North America. Feb, 2011  |  Pubmed ID: 21184904

This article provides basic information about computed tomographic colonography (CTC) and reviews the preparation, methods, and tools required for the procedure. The clinical uses for CTC (screening/diagnosis of colon cancer and colonic obstruction) are outlined, and its accuracy and validity are compared with other diagnostic methods. A summary of the benefits and risks of the test are presented and the current practicalities for implementation are addressed.

Thermal Ablation

Seminars in Roentgenology. Apr, 2011  |  Pubmed ID: 21338838

Image-guided tumor ablation refers to a group of treatment modalities that have emerged during the past 2 decades as important tools in the treatment of a wide range of tumors throughout the body. Although most widely recognized in the treatment of hepatic and renal malignancies, the role of thermal ablation has expanded to include lesions of the lung, breast, prostate, bone, as well as other organs and its clinical applications continue to increase. In the following article, we discuss the major thermal ablation modalities, their respective strengths and weaknesses, potential complications and how to avoid them, as well as possible future applications.

Thermal Ablation of Lung Tumors

Surgical Oncology Clinics of North America. Apr, 2011  |  Pubmed ID: 21377589

The 5-year survival for all stages of nonsmall cell lung cancer (NSCLC) remains bleak, having increased from 13% to just 16% over the past 30 years. Despite promising results in nonoperative patients with NSCLC and pulmonary metastatic disease, thermal ablation appears to be limited by large tumor size and proximity to large vessels. This article discusses the particular challenges of performing thermal ablation in aerated lung tissue and reviews important considerations in performing ablation including treatment complications and imaging follow-up. The article compares and contrasts the three major thermal ablation modalities: radiofrequency ablation, microwave ablation, and cryoablation.

Reduced Image Noise at Low-dose Multidetector CT of the Abdomen with Prior Image Constrained Compressed Sensing Algorithm

Radiology. Jul, 2011  |  Pubmed ID: 21436086

To assess the effect of prior image constrained compressed sensing (PICCS) on noise reduction and image quality at low-dose computed tomography (CT).

CT-guided Lung Biopsies: Pleural Blood Patching Reduces the Rate of Chest Tube Placement for Postbiopsy Pneumothorax

AJR. American Journal of Roentgenology. Oct, 2011  |  Pubmed ID: 21940564

The objective of our study was to determine whether pleural blood patching reduces the need for chest tube placement and hospital admission for pneumothorax complicating CT-guided percutaneous lung biopsy.

High-Powered Microwave Ablation with a Small-Gauge, Gas-Cooled Antenna: Initial Ex Vivo and In Vivo Results

Journal of Vascular and Interventional Radiology : JVIR. Jan, 2012  |  Pubmed ID: 22277272

PURPOSE: To evaluate the performance of a gas-cooled, high-powered microwave system. MATERIALS AND METHODS: Investigators performed 54 ablations in ex vivo bovine livers using three devices-a single 17-gauge cooled radiofrequency(RF) electrode; a cluster RF electrode; and a single 17-gauge, gas-cooled microwave (MW) antenna-at three time points (n = 6 at 4 minutes, 12 minutes, and 16 minutes). RF power was applied using impedance-based pulsing with maximum 200 W generator output. MW power of 135 W at 2.45 GHz was delivered continuously. An approved in vivo study was performed using 13 domestic pigs. Hepatic ablations were performed using single applicators and the above-mentioned MW and RF generator systems at treatment times of 2 minutes (n = 7 MW, n = 6 RF), 5 minutes (n = 23 MW, n = 8 RF), 7 minutes (n = 11 MW, n = 6 RF), and 10 minutes (n = 7 MW, n = 9 RF). Mean transverse diameter and length of the ablation zones were compared using analysis of variance (ANOVA) with post-hoc t tests and Wilcoxon rank-sum tests. RESULTS: Single ex vivo MW ablations were larger than single RF ablations at all time points (MW mean diameter range 3.5-4.8 cm 4-16 minutes; RF mean diameter range 2.6-3.1 cm 4-16 minutes) (P < .05). There was no difference in mean diameter between cluster RF and MW ablations (RF 3.3-4.4 cm 4-16 minutes; P = .4-.9). In vivo lesion diameters for MW (and RF) were as follows: 2.6 cm ± 0.72 (RF 1.5 cm ± 0.14), 3.6 cm ± 0.89 (RF 2.0 cm ± 0.4), 3.4 cm ± 0.87 (RF 1.8 cm ± 0.23), and 3.8 cm ± 0.74 (RF 2.1 cm ± 0.3) at 2 minutes, 5 minutes, 7 minutes, and 10 minutes (P < .05 all time points). CONCLUSIONS: Gas-cooled, high-powered MW ablation allows the generation of large ablation zones in short times.

Hydrodissection Utilizing an Iodinated Contrast Medium During Percutaneous Renal Cryoablation

Journal of Endourology / Endourological Society. Feb, 2012  |  Pubmed ID: 22332600

Introduction We describe our experience using an iodinated contrast solution to hydrodissect adjacent structures prior to percutaneous renal cryoablation. Technique Hydrodissection was performed prior to cryoablation with placement of a 20-gauge 15 cm introducer needle into the retroperitoneum under CT or ultrasound guidance followed by infusion of 5% dextrose in water and 2% iodinated contrast between the kidney and the adjacent organ. Ten patients underwent hydrodissection with an iodinated contrast solution at our institution. The mean tumor size was 3.1±1.2cm. The organs displaced included colon (n=7), small bowel (n=1), pancreas (n=1) and in one case both the colon and ureter were displaced. The average displacement of all organs from the kidney was 2.8 cm (range 2.2-3.5cm). There were no complications and no injuries to any adjacent structures. Conclusions The injection of iodinated contrast allows for safe mobilization and differentiation of adjacent structures from the renal tumor and parenchyma leading to potentially safer cryoablation.

Hepatobiliary MR Imaging with Gadolinium-based Contrast Agents

Journal of Magnetic Resonance Imaging : JMRI. Mar, 2012  |  Pubmed ID: 22334493

The advent of gadolinium-based "hepatobiliary" contrast agents offers new opportunities for diagnostic magnetic resonance imaging (MRI) and has triggered great interest for innovative imaging approaches to the liver and bile ducts. In this review article we discuss the imaging properties of the two gadolinium-based hepatobiliary contrast agents currently available in the U.S., gadobenate dimeglumine and gadoxetic acid, as well as important pharmacokinetic differences that affect their diagnostic performance. We review potential applications, protocol optimization strategies, as well as diagnostic pitfalls. A variety of illustrative case examples will be used to demonstrate the role of these agents in detection and characterization of liver lesions as well as for imaging the biliary system. Changes in MR protocols geared toward optimizing workflow and imaging quality are also discussed. It is our aim that the information provided in this article will facilitate the optimal utilization of these agents and will stimulate the reader's pursuit of new applications for future benefit. J. Magn. Reson. Imaging 2012;35:492-511. © 2011 Wiley Periodicals, Inc.

Visceral Obesity is Associated with Outcomes of Total Mesorectal Excision for Rectal Adenocarcinoma

Journal of Surgical Oncology. Mar, 2012  |  Pubmed ID: 21751219

General obesity, measured by the body mass index (BMI), increases the technical difficulty of total mesorectal excision (TME) but does not affect oncologic outcomes. The purpose of this study is to compare visceral and general obesity as predictors of outcomes of TME for rectal adenocarcinoma.